D56.8 vs D58.2
D56.8 and D58.2 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on D56.8
hemoglobin C disease (D58.2)
D56.8
Other thalassemias
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D55-D59
Use when the record says
- Dominant thalassemia
- Hemoglobin C thalassemia
- Mixed thalassemia
- Thalassemia with other hemoglobinopathy
Indexed under
- Variants, thalassemic
- Hemoglobinopathy › with thalassemia (mixed)
- Thalassemia › with other hemoglobinopathy (anemia) (disease)
- Thalassemia › dominant (anemia) (disease)
- Thalassemia › mixed (anemia) (disease)
D58.2
Other hemoglobinopathies
Billable
- Chapter 3
- Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
- Section
- D55-D59
Use when the record says
- Abnormal hemoglobin NOS
- Congenital Heinz body anemia
- Hb-C disease
- Hb-D disease
- Hb-E disease
- Hemoglobinopathy NOS
- Unstable hemoglobin hemolytic disease
Indexed under
- Heinz body anemia, congenital
- Hemoglobinopathy (mixed)
- Abnormal, abnormality, abnormalities › hemoglobin
- Anemia › Heinz body, congenital (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Hemoglobin › Constant Spring
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027